This review discusses recent advances in the development of metal-based anticancer drugs, highlighting new strategies and mechanisms for targeting cancer cells. Medicinal inorganic chemistry leverages the unique properties of metal ions to design novel therapeutic agents, with cisplatin being a notable example. However, cisplatin's toxic side effects have prompted the development of alternative approaches, including more selective delivery of prodrugs and non-covalent interactions with DNA. Recent trends include using metal ions as scaffolds rather than reactive centers, leading to more targeted therapies. New metal-based drugs, such as platinum(IV) complexes, offer improved stability and pharmacokinetic properties. These complexes can be activated intracellularly to release active agents, enhancing their cytotoxicity. Additionally, non-covalent interactions with DNA, such as binding to G-quadruplex structures, are being explored for their potential in targeting telomerase. Ruthenium and osmium-based complexes show promising anticancer activity through various binding modes, including intercalation and groove binding. The use of metal ions as scaffolds allows for the design of highly specific drugs, such as organometallic complexes that target specific proteins or enzymes. Examples include gold complexes targeting thioredoxin reductase and cobalt complexes targeting matrix metalloproteinases. These developments illustrate the growing potential of metal-based drugs in cancer therapy, with a focus on reducing systemic toxicity and improving drug resistance. The review emphasizes the importance of interdisciplinary approaches and the need for new assays to evaluate the efficacy of these drugs. Overall, the field of medicinal inorganic chemistry is advancing rapidly, offering new opportunities for the development of more effective and targeted anticancer therapies.This review discusses recent advances in the development of metal-based anticancer drugs, highlighting new strategies and mechanisms for targeting cancer cells. Medicinal inorganic chemistry leverages the unique properties of metal ions to design novel therapeutic agents, with cisplatin being a notable example. However, cisplatin's toxic side effects have prompted the development of alternative approaches, including more selective delivery of prodrugs and non-covalent interactions with DNA. Recent trends include using metal ions as scaffolds rather than reactive centers, leading to more targeted therapies. New metal-based drugs, such as platinum(IV) complexes, offer improved stability and pharmacokinetic properties. These complexes can be activated intracellularly to release active agents, enhancing their cytotoxicity. Additionally, non-covalent interactions with DNA, such as binding to G-quadruplex structures, are being explored for their potential in targeting telomerase. Ruthenium and osmium-based complexes show promising anticancer activity through various binding modes, including intercalation and groove binding. The use of metal ions as scaffolds allows for the design of highly specific drugs, such as organometallic complexes that target specific proteins or enzymes. Examples include gold complexes targeting thioredoxin reductase and cobalt complexes targeting matrix metalloproteinases. These developments illustrate the growing potential of metal-based drugs in cancer therapy, with a focus on reducing systemic toxicity and improving drug resistance. The review emphasizes the importance of interdisciplinary approaches and the need for new assays to evaluate the efficacy of these drugs. Overall, the field of medicinal inorganic chemistry is advancing rapidly, offering new opportunities for the development of more effective and targeted anticancer therapies.